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Rotational slit-beam marking: an advanced manual corneal astigmatic marking method for toric intraocular lens implantation

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Abstract

Purpose

To evaluate the accuracy of an advanced manual corneal astigmatic marking method for toric intraocular lens (IOL) implantation.

Methods

From 52 patients, 52 eyes with cataracts and corneal astigmatism were included. The target axis of the toric IOL was marked with the new manual marking method preoperatively and with the Zeiss CALLISTO Eye image-guided system intraoperatively. For the manual method, a slit-lamp with a minimum rotation angle of 5 degrees was used and rotated to the meridian of the toric IOL and incision axes. The relative rotational and vertical deviation of the IOL and incision axes were measured using the digital marker as a reference.

Results

There was no significant difference between the manually marked IOL axis (100.9° ± 65.62°) and the digital mark (100.8° ± 65.76°; P = 0.771). The absolute values of the relative rotational and vertical deviations of the manually marked IOL axis were small, at 2.03° ± 1.44° and 0.46 ± 0.43 mm, respectively. There was no significant difference between the manually marked corneal incision and the digital meridian (P = 0.179). Then, patients were classified into three groups based on the type of astigmatism they had. There was no significant difference in mean absolute deviation among the groups (P = 0.112). The manual incision mark had a relative rotational deviation of 1.65° ± 1.44°. The vertical misalignment of the manually marked incision axis was 0.27 ± 0.30 mm.

Conclusion

Rotational slit-beam marking could be an effective and convenient marking method for toric IOL implantation. This method could be a potential alternative in underdeveloped areas where digital image-guided systems are not available.

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References

  1. Hill W (2008) Expected effects of surgically induced astigmatism on AcrySof toric intraocular lens results. J Cataract Refract Surg 34(3):364–367. https://doi.org/10.1016/j.jcrs.2007.10.024

    Article  PubMed  Google Scholar 

  2. Mohammadi M, Naderan M, Pahlevani R, Jahanrad A (2016) Prevalence of corneal astigmatism before cataract surgery. Int Ophthalmol 36(6):807–817. https://doi.org/10.1007/s10792-016-0201-z

    Article  PubMed  Google Scholar 

  3. Chen W, Zuo C, Chen C, Su J, Luo L, Congdon N, Liu Y (2013) Prevalence of corneal astigmatism before cataract surgery in Chinese patients. J Cataract Refract Surg 39(2):188–192. https://doi.org/10.1016/j.jcrs.2012.08.060

    Article  PubMed  Google Scholar 

  4. Visser N, Beckers HJ, Bauer NJ, Gast ST, Zijlmans BL, Berenschot TT, Webers CA, Nuijts RM (2014) Toric vs aspherical control intraocular lenses in patients with cataract and corneal astigmatism: a randomized clinical trial. JAMA Ophthalmol 132(12):1462–1468. https://doi.org/10.1001/jamaophthalmol.2014.3602

    Article  PubMed  Google Scholar 

  5. Kessel L, Andresen J, Tendal B, Erngaard D, Flesner P, Hjortdal J (2016) Toric intraocular lenses in the correction of astigmatism during cataract surgery: a systematic review and meta-analysis. Ophthalmology 123(2):275–286. https://doi.org/10.1016/j.ophtha.2015.10.002

    Article  PubMed  Google Scholar 

  6. Ma JJ, Tseng SS (2008) Simple method for accurate alignment in toric phakic and aphakic intraocular lens implantation. J Cataract Refract Surg 34(10):1631–1636. https://doi.org/10.1016/j.jcrs.2008.04.041

    Article  PubMed  Google Scholar 

  7. Felipe A, Artigas JM, Diez-Ajenjo A, Garcia-Domene C, Alcocer P (2011) Residual astigmatism produced by toric intraocular lens rotation. J Cataract Refract Surg 37(10):1895–1901. https://doi.org/10.1016/j.jcrs.2011.04.036

    Article  PubMed  Google Scholar 

  8. Mustafa OM, Prescott C, Alsaleh F, Dzhaber D, Daoud YJ (2019) Refractive and visual outcomes and rotational stability of toric intraocular lenses in eyes with and without previous ocular surgeries: a longitudinal study. J Refract Surg 35(12):781–788. https://doi.org/10.3928/1081597x-20191021-03

    Article  PubMed  Google Scholar 

  9. Viestenz A, Seitz B, Langenbucher A (2005) Evaluating the eye’s rotational stability during standard photography: effect on determining the axial orientation of toric intraocular lenses. J Cataract Refract Surg 31(3):557–561. https://doi.org/10.1016/j.jcrs.2004.07.019

    Article  PubMed  Google Scholar 

  10. Ventura BV, Wang L, Weikert MP, Robinson SB, Koch DD (2014) Surgical management of astigmatism with toric intraocular lenses. Arq Bras Oftalmol 77(2):125–131. https://doi.org/10.5935/0004-2749.20140032

    Article  PubMed  Google Scholar 

  11. Popp N, Hirnschall N, Maedel S, Findl O (2012) Evaluation of 4 corneal astigmatic marking methods. J Cataract Refract Surg 38(12):2094–2099. https://doi.org/10.1016/j.jcrs.2012.07.039

    Article  PubMed  Google Scholar 

  12. Woo YJ, Lee H, Kim HS, Kim EK, Seo KY, Kim TI (2015) Comparison of 3 marking techniques in preoperative assessment of toric intraocular lenses using a wavefront aberrometer. J Cataract Refract Surg 41(6):1232–1240. https://doi.org/10.1016/j.jcrs.2014.09.045

    Article  PubMed  Google Scholar 

  13. Elhofi AH, Helaly HA (2015) Comparison between digital and manual marking for toric intraocular lenses: a randomized trial. Medicine (Baltimore) 94(38):e1618. https://doi.org/10.1097/md.0000000000001618

    Article  Google Scholar 

  14. Webers VSC, Bauer NJC, Visser N, Berendschot T, van den Biggelaar F, Nuijts R (2017) Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery. J Cataract Refract Surg 43(6):781–788. https://doi.org/10.1016/j.jcrs.2017.03.041

    Article  PubMed  Google Scholar 

  15. Raucau M, El Chehab H, Agard E, Lagenaite C, Dot C (2018) Toric lens implantation in cataract surgery: automated versus manual horizontal axis marking, analysis of 50 cases. J Francais d’ophtalmologie 41(1):e1–e9. https://doi.org/10.1016/j.jfo.2017.11.002

    Article  CAS  Google Scholar 

  16. Kaur M, Shaikh F, Falera R, Titiyal JS (2017) Optimizing outcomes with toric intraocular lenses. Indian J Ophthalmol 65(12):1301–1313. https://doi.org/10.4103/ijo.IJO_810_17

    Article  PubMed  PubMed Central  Google Scholar 

  17. Zhou F, Jiang W, Lin Z, Li X, Li J, Lin H, Chen W, Wang Q (2019) Comparative meta-analysis of toric intraocular lens alignment accuracy in cataract patients: image-guided system versus manual marking. J Cataract Refract Surg 45(9):1340–1345. https://doi.org/10.1016/j.jcrs.2019.03.030

    Article  PubMed  Google Scholar 

  18. Panagiotopoulou EK, Ntonti P, Gkika M, Konstantinidis A, Perente I, Dardabounis D, Ioannakis K, Labiris G (2019) Image-guided lens extraction surgery: a systematic review. Int J Ophthalmol 12(1):135–151. https://doi.org/10.18240/ijo.2019.01.21

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mayer WJ, Kreutzer T, Dirisamer M, Kern C, Kortuem K, Vounotrypidis E, Priglinger S, Kook D (2017) Comparison of visual outcomes, alignment accuracy, and surgical time between 2 methods of corneal marking for toric intraocular lens implantation. J Cataract Refract Surg 43(10):1281–1286. https://doi.org/10.1016/j.jcrs.2017.07.030

    Article  PubMed  Google Scholar 

  20. Varsits RM, Hirnschall N, Doller B, Findl O (2019) Evaluation of an intraoperative toric intraocular lens alignment system using an image-guided system. J Cataract Refract Surg 45(9):1234–1238. https://doi.org/10.1016/j.jcrs.2019.04.009

    Article  PubMed  Google Scholar 

  21. Titiyal JS, Kaur M, Jose CP, Falera R, Kinkar A, Bageshwar LM (2018) Comparative evaluation of toric intraocular lens alignment and visual quality with image-guided surgery and conventional three-step manual marking. Clin Ophthalmol 12:747–753. https://doi.org/10.2147/opth.S164175

    Article  PubMed  PubMed Central  Google Scholar 

  22. Carey PJ, Leccisotti A, McGilligan VE, Goodall EA, Moore CB (2010) Assessment of toric intraocular lens alignment by a refractive power/corneal analyzer system and slitlamp observation. J Cataract Refract Surg 36(2):222–229. https://doi.org/10.1016/j.jcrs.2009.08.033

    Article  PubMed  Google Scholar 

  23. Cha D, Kang SY, Kim SH, Song JS, Kim HM (2011) New axis-marking method for a toric intraocular lens: mapping method. J Refract Surg 27(5):375–379. https://doi.org/10.3928/1081597x-20101005-01

    Article  PubMed  Google Scholar 

  24. Visser N, Berendschot TT, Bauer NJ, Jurich J, Kersting O, Nuijts RM (2011) Accuracy of toric intraocular lens implantation in cataract and refractive surgery. J Cataract Refract Surg 37(8):1394–1402. https://doi.org/10.1016/j.jcrs.2011.02.024

    Article  PubMed  Google Scholar 

  25. Montes de Oca I, Kim EJ, Wang L, Weikert MP, Khandelwal SS, Al-Mohtaseb Z, Koch DD (2016) Accuracy of toric intraocular lens axis alignment using a 3-dimensional computer-guided visualization system. J Cataract Refract Surg 42(4):550–555. https://doi.org/10.1016/j.jcrs.2015.12.052

    Article  PubMed  Google Scholar 

  26. Onishi H, Torii H, Watanabe K, Tsubota K, Negishi K (2016) Comparison of clinical outcomes among 3 marking methods for toric intraocular lens implantation. Jpn J Ophthalmol 60(3):142–149. https://doi.org/10.1007/s10384-016-0432-6

    Article  PubMed  Google Scholar 

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Author notes

  1. Qianru Wu and Yinan Liu have contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People’s Republic of China

    Qianru Wu, Yinan Liu, Hongyuan Cai, Chun Zhang & Xiaoyong Chen

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  1. Qianru Wu
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  2. Yinan Liu
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  3. Hongyuan Cai
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  4. Chun Zhang
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Contributions

Xiaoyong Chen contributed to the ideas and design of study. Hongyuan Cai and Yinan Liu performed the experiment. Qianru Wu collected data, helped in the statistical analysis and drafted the manuscript. Yinan Liu and Chun Zhang reviewed and revised the manuscript. Qianru Wu and Yinan Liu contributed equally to this article, they are co-first authors of the article. All authors read and approved the final manuscript.

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Correspondence to Xiaoyong Chen.

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All the authors have no financial or proprietary interest in any product, method or material described in this manuscript. They declare that they have no competing interests.

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The study followed the tenets of the Declaration of Helsinki and was approved by the Peking University Third Hospital Medical Science Research Ethics Committee.

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All patients provided written informed consent.

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Wu, Q., Liu, Y., Cai, H. et al. Rotational slit-beam marking: an advanced manual corneal astigmatic marking method for toric intraocular lens implantation. Int Ophthalmol 40, 3115–3125 (2020). https://doi.org/10.1007/s10792-020-01498-y

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  • DOI: https://doi.org/10.1007/s10792-020-01498-y

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